Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 225700000X | WA |
NPI | 1033400734 |
---|---|
Provider Name | Mr. Rodney Cal Hair |
First Address | Seattle, WA 98133-6969 |
Second Address | Seattle, WA 98133-6969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2011 |
Last Update Date | 28/04/2011 |